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General NPI Number Information
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NPI Number | 1740325919
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Entity Type | Organization
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Legal Business Name | ST. JOSEPH'S AREA HEALTH SERVICES
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 600 PLEASANT AVE S
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City | PARK RAPIDS
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State | MN
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Zip | 56470-1431
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Country | US
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Telephone | 218-732-3311
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Fax | 218-237-5585
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Provider Business Mailing Address
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Address Line | 600 PLEASANT AVE S
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City | PARK RAPIDS
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State | MN
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Zip | 56470-1431
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Country | US
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Telephone | 218-732-3311
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Fax | 218-237-5585
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Authorized Official
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Title or Position | CEO
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Name | MR. BEN KOPPELMAN
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Credential |
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Telephone | 218-732-3311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 275N00000X
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Taxonomy Name | Medicare Defined Swing Bed Hospital Unit
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License Number | 335388
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License Number State | MN
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